Hair Loss During Chemotherapy

What to Expect and What You Can Do About It

Believe it or not, hair loss (alopecia) due to chemotherapy
is one of the most distressing side effects of
chemo treatments. Hair loss happens because the
chemotherapy affects all cells in the body, not just the cancer
cells. The lining of the mouth, stomach, and the hair follicles
are especially sensitive because those cells multiply rapidly
just like the cancer cells. The difference is that the normal cells
will repair themselves, making these side effects temporary.

Hair loss does not occur with all chemotherapy. Whether
or not your hair remains as it is, thins, or falls out depends
on the drugs and dosages. Hair loss may occur as early as
the second or third week after the first cycle of chemotherapy,
although it may not happen until after the second cycle
of chemotherapy.

Hair loss can be sudden or slow. You may lose all of
your hair or just some of it. Often, it comes out in clumps
rather than an even pattern. It is common for hair loss to
include hair that grows anywhere, including eyelashes, eyebrows,
and even pubic hair.

Be prepared for your “new” hair to possibly have a slightly different
color, texture, or curl.

In almost all cases of chemotherapy-induced hair loss,
your hair will resume growth after treatments. It may take
from three to six months after therapy is completed, or it
may start growing back while you are still receiving chemotherapy.
Be prepared for your “new” hair to possibly have a
slightly different color, texture, or curl.

Can you prevent hair loss during chemo treatments?
Currently, there is no known prevention for hair loss due to
chemotherapy. Through the years, attempts have been made
to reduce hair loss by using tight bands or ice caps. These
techniques were thought to reduce the blood flow to the hair
follicles, thus limiting the chemotherapy exposure. Unfortunately,
these techniques did little more than cause headaches,
thus they have been abandoned in most settings.

What can be done to manage hair loss due to
chemotherapy?
Given that hair loss cannot be prevented,
management focuses on your own comfort, or discomfort,
with baldness and on keeping your head warm if you live
in a cool climate. The following are options to consider.
The best option is the one that is most comfortable for you.

Opt for a short hairstyle. Cut your hair short if you are
expecting hair loss during chemotherapy. Since hair often
does not fall out evenly, some find losing short hair is less
distressing. Some people shave their heads once the hair
begins to fall out.

Wear a wig. If you are interested in purchasing a wig,
the best time to do this is before you lose any hair. This
helps the stylist create the best match. Many insurance
companies will pay for a wig, so be sure you have it written
as a prescription from your doctor (usually written as “cranial
prosthesis”). There are wig stylists who specialize in
wigs for alopecia (hair loss). Check online or in your yellow
pages or ask at the doctor’s office.

Cover your head with caps or scarves. Some people
find that the easiest and most comfortable options are caps
and scarves. Your options range from those items you may
already own to custom items made expressly for people who
are undergoing chemotherapy.

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Excerpted with permission from Chemocare.com, a program of the Scott Hamilton
CARES Initiative.

If you are worried about hair loss from cancer treatments,
contact your local chapter of the American Cancer Society. ACS
sponsors a program called “Look Good…Feel Better.” This program
addresses ways to tie scarves, how to take care of your wig,
and other steps you can take to make yourself look and feel better
while experiencing hair loss during and after chemotherapy. For
more information, go to LookGoodFeelBetter.org. Click here for more information from Coping.

This article was published in Coping® with Cancer magazine,
November/December
2009.